Your Program Team
Roles and Responsibilities
Notification Program Manager (NPM)
This is the person who oversees and is ultimately in charge of the Notification Program – probably
you! If not, the ideal person for this role would be the head of trauma services, emergency services
or the director of nursing. The NPM works with the Trauma Notification Manager and Program
Coordinator to:
•Review current notification practices
• Create and Develop a customized notification program for your
facility
• Obtains management approval for and signs off on the details of the
hospital’s notification program
• Assigns team members to the roles they will play during notifications
• Oversees the TNM and Program Coordinator as they develop
communications to staff members about the program’s rollout, perform
the program kickoff and the actual execution of the pilot and program
in the emergency department.
The role of Notification Program Manager (NPM) will be performed by:
Trauma Notification Manager (TNM)
This is the person who holds a management position within the emergency department and will be
responsible for the rollout and execution of the Notification Program. The TNM works with the NPM
to:
• Consult on the creation and development of the customized
notification program for the facility.
• Supervise team members who perform notifications, answer
questions and address problems.
• In a smaller facility, this TNM might actually perform the notification
process her/himself.
• As the pilot progresses, reports back to the NPM to discuss any
changes that need to be made or report on successes.
The role of Trauma Notification Manager (TNM) will be performed by:
Your Program Team
Notification Program Coordinator (PC)
This is the person who is responsible for scheduling the overall timetable of the program. The PC will:
set start and end dates for each of the five phases, keeping the team on task and on time, and keep
track of issues and report on the final results. The PC will also gather current ED statistics from the
previous year or six months (if possible) to determine the current effectiveness of procedures and set
measurable goals for improvement.
• Set start and end dates for each of the five phases during the creation
of the notification program, keeping the team on task and on time
• Make sure that the notification team has everything that they need on
the patient care floor, like the tracking notebook and worksheets and
that everything is kept in order during the pilot.
• Keep track of any issues that arise and report on the final results
• In a large facility, the PC can gather current ED statistics from the
previous year or six months (if possible) to determine the current
effectiveness of procedures and set measurable goals for
improvement.
The role of Notification Program Coordinator (PC) will be performed by:
Training & Communications Coordinator
In a smaller facility this role can easily be assumed by the Trauma Notification Manager.
• Communicate the new processes and roles to staff members and
create the documents used to train the team members who will be
performing notifications.
• Make sure that all departments are kept abreast of the changes
including the ED staff, social work, risk management, pastoral care,
patient advocates and anyone else who will be a part of the notification
process
The communication and kick off could take place in a half day seminar, or for a smaller facility could
simply consist of a memo with a guide covering the new program and work flow, the role each person
will be playing and the results that the hospital is expecting.
The role of Training & Communications Coordinator (TC) will be performed by:
Notification Team Roles
1.
The Assessor
Ideally this role will be performed by
the Triage Nurse, Nurse Manager, or
a Resident – whoever normally
assesses patients on arrival. Along
with their normal assessment
procedure, they will determine if the
patient is unconscious or altered and
if they are unable to give informed
consent. They will then determine if
the patient is alone, or is
unaccompanied by next of kin or a
surrogate decisionmaker. If they are
unconscious, unable to give
informed consent and
unaccompanied by next of kin, the
Assessor will begin a Seven Steps
Chart Worksheet and hand the
notification over to the person in the
Notifier role.
3.
2.
The Notifier
The Notifier is an Emergency
Department nurse or unit
coordinator who gathers any
information that is physically on the
patient and performs the steps
necessary to locate a next of kin
contact or identify the patient if
he/she is a John/Jane Doe. Once
the contact name/number is found,
the Notifier makes the notification
calls and follows the case until the
next of kin arrives on scene.
Once they have arrived the Notifier
will greet the family and make sure
that they are seen by the patient’s
nurse or physician. If information is
not found on the patient, or if the
NOK doesn’t call back within the
time limit on the Chart Worksheet,
the patient’s Chart Worksheet and
information will be handed off to the
Follow Up.
The Follow Up
The Follow Up person is a staff member in social services, patient
advocacy or pastoral care, who has two specific duties. First, this is
the person who comes on the scene if all of the Notifier’s efforts to
identify a patient or find a next of kin contact within the given amount
of time, have been unsuccessful. The follow up person takes
ownership of the patient’s Chart Worksheet and other information
and continues to try and locate his identity or if identified, his NOK
contact for a specified period of time. If this is not successful, the
patient’s case is handed over to its final destination according to
facility policy, depending on the patient’s diagnosis and outcome.
Follow Up also receives the complete worksheets each time a
notification is made to: perform quality assurance, call the family or
visit the patient to ensure that everything is fine, keep the worksheets
in a file to be used for reference, patient statistics, metrics or in
service training.
Notification Tracking System Notebook
Creating the Notification Tracking System Notebook
Since most of the Notifications will take place in the Emergency Department, that’s where the Tracking
Notebook should reside. Depending on your program, it will include:
• A Sample Patient Tracking Sheet and blank tracking sheets?
• Definitions of Notification Team Roles and Responsibilities?
• The Seven Steps
• Your Facility’s Notification Work Flow
• Your Notification Policies
• Tips on Locating Emergency Contact Information
• Copies of Tip Sheets for Locating Emergency Contact Information, John Doe
identification, or specialty notifications like pediatric, or Alzheimer’s patients.
The Notebook should be in a place that is safe, easy for your staff to locate, yet in a place where
patients, visitors or non-staff members will not be able to view it.
If you have notification reference material that doesn’t fit in the Notebook, does the team know where
to find it?
Does it include a list of Notification Team Members and their pager numbers in the Tracking Notebook
for quick identification when they are needed?
Are Patient Tracking Worksheets available for Assessors in triage or any other area where they
perform initial patient assessments?
Assessing Your Patient’s Ability to Communicate
The next time you’re caring for a
patient with compromised
communication ability, take a
moment to see your patient’s
surroundings from her perspective.
If your patient’s family and friends
are not at the hospital with her or
can’t come often, are there tools
you can provide your patient that
will facilitate communication with the
outside world?
Mobility Limitations
• If your patient can speak, is the
telephone close enough to her for
her to use?
• Does she need help dialing? Is
she able to see well enough to read
a number off a piece of paper or out
of her address book?
• If your patient is unable to hold a
telephone, would she benefit from a
speakerphone or a cell phone?
Hearing/Speech Limitations
• If your patient can’t speak, ask
her to indicate if she would like to
have someone called for her, and
task a patient representative or
volunteer to hold the phone up to
her ear and facilitate their
communication.
• If your patient is deaf, make sure
that your facility has TTY
telephones to connect with family
members.
• If your patient is blind, make sure
that she has Braille writers or other
devices to help her communicate.
• Take a moment to call the
department in your facility that deals
with hearing or vision-impaired
patients. They may have more tools
or ideas that can bridge difficulties
and enhance communication.
• Another idea for patients who can’t
speak, is patient Internet access. If your
hospital has it available, it can be a real
lifesaver, allowing a patient to type an
email, a text message or to supervise
while a message is typed for them. If
your facility doesn’t have Internet access
for patients, either you or another team
member can use a smart phone or cell
phone to send an email or text a
message for them, facilitating
emergency communication with a loved
one.
Or they can email you a photo of
themselves to show to the patient or
an email that your patient can read for
himself.
• For patients who have a temporary
physically impairment, like a broken jaw,
encourage them to use patient Internet
access or their cell or smart phones (if
allowed) to email, text and keep in touch
with family or children who might not be
able to visit in person.
I don’t think we have to tell anyone,
how much that bit of video can mean
to a family.
Don’t Forget About Technology!
Surgeons are now using Twitter to keep
families apprised of patient’s progress
during surgery, while families who are
apart during emergencies, are using
Facebook and MySpace to keep each
other up to date.
You can use that same technology to
help a critically ill or dying patient
communicate with family members who
might not make it to the hospital in time
to be with them.
How? With your smart phone!
Most smart phones have the ability to
record video, audio and take photos, all
of which can be sent or received via
email right from the phone. Let’s say
you have a patient who might not make
it through the night. His family is about
to board a plane, but won’t arrive for
three or four hours. Even if you aren’t
allowed to turn your personal cell phone
on to receive calls in the ICU, the family
can record a video or audio message on
their own phone and email it to you, so
you can play it for the patient something
you can do without the phone actually
being on.
You can do the same thing at your
end. Let’s say that your patient is alert
and oriented now, but you both realize
that he might not live. By using your
smart or cell phone with video or audio
recording capability, he can record a
final message to a loved one, that can
later be emailed to the family.
Or let’s say that your patient is a John
Doe or that she was a part of a mass
casualty and even though you’re
relatively positive you have the right
name with the right person, the family
member is still in transit.
You can snap a quick photo and email
it to the family, hastening the
identification.
Communication isn’t just a patient’s
right – for many it can be their only link
to the outside world, or a life-renewing
source of strength and love. Combine
that with outstanding medical care and
watch the miracles flow.
Analyze: Notification Workflow
Quick Tips For
Finding Contact
Information
Where To Look For Patient’s Emergency Contact Information
Inside their Wallet
Driver’s license
Credit Cards
Photo ID card/Company ID card
Cell phone, Phone contacts,
Speed dial
Information on flash drives, CDs
Medic Alert or Safe Return
Bracelet
Contacts on their Smartphone
Name on the Letterhead of any
Personal Address book
Business Correspondence
Insurance Card
Contact Page of their Date Book
Business Cards
In the Glove Compartment or on
Contacts on their Laptop
the Visor of their Car
Computer
Their Car Registration or
Email addresses or Web
License Plate
Sites
Inside Shoewallet/Go Wallet
Advice From Ground Zero 9/11
To prepare for Mass Casualty Incidents, add a few lines to
your emergency intake sheet, to include the location that the
victim was found, a place for the paramedics or person who
brought him in, to jot down any other information on the
patient, and a quick description of any personal effects brought
in with him. This can help match patients to their belongings
and contact information later on, or help their families identify
them using the approximate location in which they were found.
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Where To Look For Children’s Emergency Contact
Information
Book Bags and Lunch Boxes
School Name Stamped in
School Books
Names in Notebooks on
Homework, Work Sheets
Cell Phone Speed Dial, Contact
List, Photo Screensavers
Medic Alert Bracelet
MP3 Player
Inside Their Clothes or
Underwear
Names & Numbers of Friends
Previous Hospital Records or
Birth Records
Advice From Children’s
Memorial Hospital/Chicago
School-age kids almost always
have a backpack. If we don’t find
anything there, we’ll check our
records to see if the child is in
our system and begin to gently
probe the child for information.
We ask them where their house
is, what their school looks like,
information about their friend’s
houses, maybe a familiar
landmark on the corner like a
7/11 or the name of a park…
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Dealing with John Does
Amnesia & Dementia
Patients
Look for Key Ring/Convenience Cards from Grocery or Video Rental Stores. If you find a convenience card
on your patient’s key ring and can’t identify the patient in any other way, call the store, tell them you have
an emergency and have them give you or contact the patient’s home number.
Check to see if the Patient has a Safe Return Bracelet from the Alzheimer’s Association, a Go Wallet or a
piece of Medic-Alert jewelry. If they do, contact the toll free number to locate emergency contact
information.
If you only have a patient’s address but no phone number, or a location where an incident took place, try
looking it up in the Haines Criss + Cross Directory, or other reverse directory. To get a copy of the
directory, go to their web site at http://www.haines.com, call 1-800-254-3449, or email them at
criscros@haines.com.
Even if your patient has amnesia, if he is able to talk, be sure to listen carefully to everything he says.
People may remember a name or a place. One patient began repeating numbers apparently at random. A
nurse began to write it down and realized it could be parts of a phone number. When they called it, they
reached his grandmother in Canada. Another time emergency personnel found a man’s identity because
he was able to remember the name of a store. They called it and found out that a friend there had been
desperately searching for him.
If the patient appears to be homeless, look at all of his clothing, even in the seams of his shirt, inside his hat
or for papers sewn into the lining of their coat. Many homeless people have been known to safeguard this
information in case of emergency.
If the patient is unconscious or has no identification anywhere on his
body, the trauma team will need to get a complete description of the
patient, noting all identifying marks and any details of the location
where he was found, then notify the local police to check to see if
he’s been reported missing. Fingerprinting may also aid in
identification.
If all else fails, try showing photos of the patient’s personal effects, as
well as circumstances surrounding the incident or accident, in the
media. Be sure to hold a few details back, so that you can be sure
the person calling is actually a relative of the patient. Have the
description of the patient sent to the front desk personnel and ED
staff as well. If a person comes to the hospital searching for a
patient whose name isn’t found on the patient roster, ask for a
description of the person they’re seeking – it just may be your John
Doe. When a match seems to be imminent, have that family
member or friend present evidence that they are indeed related to, or
a friend of the patient, and note all of the proceedings in the patient’s
medical record.
Don’t Forget Technology!
If you find a name or an email
address or even a company
name on your patient, and have
no other clues to go on, don’t
forget to Google it. Typing the
small facts you know into a
search engine can fill in the
details. A person’s name plus a
company name can give you
their contact number, a link to
their personal web site or a
Facebook or MySpace listing.
And from there, you can easily
find their friends or contact
information.
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